Healthcare Provider Details

I. General information

NPI: 1225065469
Provider Name (Legal Business Name): DAVID ANDREW WOLFE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL WAY- INDIAN HEALTH HOSPITAL
CROW AGENCY MT
59022
US

IV. Provider business mailing address

163 EMERALD HILLS DR
BILLINGS MT
59101-7229
US

V. Phone/Fax

Practice location:
  • Phone: 406-638-3309
  • Fax: 406-638-3572
Mailing address:
  • Phone: 406-638-3339
  • Fax: 406-638-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number# 106
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: